As the law stands, newly qualified consultants can walk straight into the operating theatre and perform the full repertoire of cosmetic surgery procedures for anyone who asks.  But in a recent survey, both doctors and patients have expressed their dissatisfaction with the status quo – and called for more specialist training for cosmetic surgeons to be made a legal requirement. The poll was conducted on 2,000 women and 500 doctors to coincide with the Clinical Cosmetic and Reconstructive Expo (the UK’s biggest plastic surgery conference), which takes place next month. 93% of the doctors surveyed said that they didn’t feel newly qualified surgeons were of the required standard to provide complex specialist surgeries like facelift and breast enlargement. Even though the law says otherwise, and NHS training is deemed to be sufficient.

Which leaves a vanishingly small one in 14 clinicians who felt things were fine the way they are, and no accredited training was necessary. Three-quarters of the patients surveyed also said they would feel more confident having cosmetic surgery if they knew their surgeon had undertaken further specialist training.

When asked about non-surgical cosmetic treatments, including injectables and laser treatment, both doctors and patients agreed that comprehensive specialist training was necessary. A minority of the doctors surveyed (around a third) thought medical professionals should have a minimum of three months’ training before being allowed to perform laser treatment.

Calls and campaigns to improve standards in the industry seem to be gathering momentum. This poll comes only days after Health Education England (HEE) released the first part of their review into training for non-surgical procedures.

And the organisation Save Face is currently creating a voluntary register of non-surgical cosmetic practitioners who have been thoroughly vetted by doctors before accreditation.

We will keep a close eye on any outcomes arising from this new scrutiny on what has hitherto been a largely unregulated industry. From our point of view as medical professionals, anything that improves patient safety and raises the standard for those entering the cosmetic arena can only be healthy for the industry – and improve its reputation beyond measure.


As an aesthetic practitioner it goes without saying that you want to deliver the best possible service to your clients. However there may be occasions when things go wrong and a claim is made against you. We know how distressing this can be for not only the patient but also the practitioner.

Eddie Hooker, CEO of Hamilton Fraser Cosmetic Insurance, recommends the following five steps that will help in the event of a claim being made against you:

1. Obtain full consent

Always ensure you obtain full consent from your client before the start of any treatment. Set out all the risks and benefits as well as any potential side effects and ensure your client has read and absorbed all of the information before they consent to the treatment they will be undergoing.

2. Keep detailed records

Always make sure you maintain a written record of all of the treatments you have provided, on the date you provided it. This should include machine settings together (where appropriate) with before and after photographs. You will need to keep your notes for 10 years in case a claim may arise in the future. You will also need to keep your equipment in good working order and up to date in accordance with manufacturers’ guidelines.

3. Stay up to date with your training

Ensure you can demonstrate you are fully trained and competent by undergoing initial training and also regular re-training throughout your career and retain all certificates.

4. Manage expectations

It is important to ensure the client has realistic expectations of the outcome of the treatment and whether (and when) any top up treatments may be necessary. Ensure that you allow sufficient time at consultation to cover this.

5. Medical due diligence

Make sure you get a full medical history from the client and explain full aftercare treatment and what they need to carry out themselves.

It is important to ensure that you have adequate insurance protection in case the worst happens. At Hamilton Fraser Cosmetic Insurance we have been insuring aesthetic practitioners for many years and understand the aesthetic industry, so please contact us on 0800 63 43 881 or email [email protected] for insurance advice and a free quotation.

Who knew a takeover bid in the pharma industry would be so thrilling? The battle between Allergan Vs Valeant is shaping up like an epic tennis match, with shot after shot screaming back over the net.

The last was from Valeant, who announced they were seeking to bypass Allergan’s board of Directors and take their hostile bid directly to shareholders.

But now Botox maker Allergan have hit a blistering return. To head off the $53 billion hostile takeover bid, the board are preparing a slew of measures – including taking on debt to buy back their own shares.

Also on the table is a plan to make acquisitions of its own (anything Valeant can do…), as well as a round of spending cuts to increase shareholder value, according to Chief Executive David Pyott.

The hope is that these measures will be enough to persuade shareholders that Allergan is better off going it alone.

It’s thought that Allergan will officially reveal their masterplan when they release their second-quarter results later this month. But even then it seems the battle won’t be over.

Valeant have hit back, saying they already have enough shareholders on side to call a meeting to try and replace Allergan board members with nominees who support their takeover bid. They need the support of shareholders who hold at least 25% of the company’s shares.

Financial Analyst Ronny Gal says that while it’s possible for Allergan to swing things in their favour, they will find it challenging.

“When I run my numbers, a buyback alone doesn’t quite cut it. A buyback plus another round of cost cuts, or the acceleration of the discussed cost savings, does.”

An acquisition could help them, according to Gal, but only if it increases their profits – and quickly. To win round short-term investors, he says, Allergan needs to deliver another $10 per share in 2015 or $11 per share in 2016.

Get comfortable. Allergan Vs Valeant is going to run and run…

This is the story that just won’t go away. We recently wrote about Botox maker Allergan rejecting a takeover bid by Canadian pharmaceutical company Valeant. But it seems Valeant have rhino hide, and won’t be letting rejection put them off.

It’s been reported that the conglomerate will this week launch an exchange offer for Allergan Inc, which will allow them to bypass the board of Directors and take their hostile bid directly to shareholders.

Allergan has already rejected Valeant’s $53 billion offer, but the company’s largest shareholder, Pershing Square Capital Management, has indicated it will be seeking a special meeting later this year to change most of Allergan’s board.

To trigger the meeting, Pershing needs to ensure the support of 25% of Allergan’s shareholders – an increase of 15.3% on its own holding of 9.7%.

Despite the challenge ahead, Valeant’s Chief Financial Officer Howard Schiller is bullish about their chances of shoring up the support. He pointed out that more than 50% of Allergan’s shares have traded since news of Valeant’s offer first leaked out on 21st April.

Talking about the controversy surrounding their approach to Allergan, Valeant’s Chief Executive Officer Mike Pearson, said:

“Hostile is not our preferred approach. But this deal was so strategic and financially compelling that it really makes sense.”

It increasingly seems that it’s a question of when, not if, this deal will finally go ahead.


After the publication of the long-awaited Keogh Report last year, Health Education England are working with regulators and royal colleges to review the qualifications required to carry out non-surgical cosmetic procedures in the Health Education Review . Their recommendations are expected at the end of April.

The outcome of the review could be a pivotal moment in the industry, both for professionals and patients. Our team have been following HEE’s research as closely as we can, including attending one of their recent workshops, to keep up to speed with any developments.

So what might the HEE review mean for professionals in the industry?

In our opinion, any measures to improve standards can only be good for the industry and benefit both patients and practitioners. We would absolutely welcome any reforms that mean our delegates can go out and practice the treatments they have learned with us as confidently and safely as possible.

Of course, while the outcomes of the review are as yet unknown, we currently don’t know whether HEE will suggest any changes. But if new recommendations are made, we will work with all our delegates, past and present, to ensure they meet the new standards.

We are dedicated to offering the highest quality aesthetic training in the UK, and best practice is always our aim. With that in mind, we will continue to keep abreast of any changes and be sure to keep you informed along the way.

Cosmetic Courses are one of the UK’s most established providers of medical aesthetic training, with over 10 years’ experience to date. Our expert team come from a variety of medical backgrounds, and diverse industries, and all make it their business to keep at the very forefront of developments in the industry. For more information on Cosmetic Courses or the training we offer, contact the team on 01844 390110 or email [email protected].

This weekend, 8-9th March, Cosmetic Courses are exhibiting at the ACE Conference If you’re going to be there, come along and say hello!

The ACE Conference is one of the biggest events in the industry, and it’s our first time exhibiting, so we’re really looking forward to it.

Lots of preparations have been made over the last few weeks, with the whole team working hard behind the scenes. Now it’s almost here, we’re excited to find out what the conference is like, and get the chance to meet lots of people in the industry.

You’ll be able to find us at Stand 31, where we’ll be offering lots of practical help for people looking to start or develop their aesthetic careers, including:

  • * Exclusive discounts – book a course during the conference and receive £100 discount!
  • * Advice and information on new training courses
  • * Upcoming course dates
  • * Business advice

On the Saturday afternoon at 3pm, our Clinical Director, Adrian Richards, and Aesthetic Nurse and Trainer, Mel Recchia, will be performing a live demonstration of lip augmentation with dermal fillers at ACE Conference.

The idea is to give people an introduction to the treatment, as well a taster of what they can expect when they come along to one of our courses. So if you are coming to the conference and interested in learning lip filler techniques, it should be well worth you coming along.

If you don’t have tickets for the event but think you might want to attend, the ACE conference takes place at the Business Design Centre in Islington, and entry to the exhibition is free (though if you want to attend lectures, seminars and masterclasses, a charge is payable).

For anyone who is going to be there, whether exhibiting or attending, we’ll see you there.

York University has recently undertaken research in to the potential effects of Brits travelling abroad for cheaper medical procedures.

These include areas of treatment that aren’t currently covered by the NHS, or have reduced availability or, alternatively, are available but at a higher cost than in some other countries. The researchers took in to account dentistry, cosmetic surgery including treatments such as Botox, bariatic (weight loss) surgery and fertility services.

They reached the conclusion that so-called ‘medical tourism’ should be considered risky and potentially unsafe, and that as it currently stands patients were not aware of all the risks involved.

The main motivating factors for people electing for treatment abroad were positive recommendations from friends and family, and the often far cheaper price than the equivalent procedure in the UK. The potential repercussions of such trips did not seem to figure as heavily in decision-making.

The researchers also recommended that GPs need to play a larger role in educating patients as to the risks associated with travelling abroad for medical procedures.

63,000 UK patients travel abroad for medical treatment each year, with many unaware of where they stand should things go wrong. It’s likely that they will have no redress or legal protection within the country they have travelled to and will instead have to travel back to the UK and undergo potentially very expensive corrective treatment.

Cosmetic Courses offer expert aesthetic training to medical professionals from around the world. Contact the team on 01844 390110 or email [email protected] for information on our current course programme.

Winner of last year’s The Apprentice, Dr Leah Totton, this week launched the first of her cosmetic clinic ‘Dr. Leah’, joined by businesswoman and The Apprentice star Karren Brady. They will be offering various treatments, including cosmetic procedures such as Botox and liposuction.

Dr Totton came under fire with her business plan, which won her £250,000 of Lord Sugar’s investment, as she has not previously worked in aesthetic medicine, despite having trained in the techniques.

Her business idea came at the same time as the government-initiated Keogh review looked in to practices within the medical beauty sector, including who can administer such procedures and what medical and aesthetic training ought to be required. At the time previous BAAPS Chairman Nigel Mercer likened Dr Totton’s offering such procedures as putting “a hairdresser in charge of cosmetic surgery”.

Despite this controversy the planned clinics are going ahead, with the first on London’s Harley Street. Although Dr Totton, from Londonderry in Ireland, has decreed she will not administer Botox to the under-18s there are still question marks over how much publicity such clinics should receive, and whether services such as Botox and liposuction should be performed in a beauty therapy rather than in medical surroundings.

Runner up on the show, Luisa Zissman is currently appearing on Channel 5’s Celebrity Big Brother.

The IAPS (Irish Association of Plastic Surgeons) is calling for tighter regulation for the sector, specifically, demanding that doctors have to undergo specialist training before practising in plastic surgery. At the moment any qualified doctor can offer plastic surgery, and critics of this system argue that this does little to protect the patient.

At the time that British Association of Aesthetic Surgeons held their annual meeting in Dublin, outside London for the first time, the IAPS used the opportunity as a springboard to discuss changes in Irish law.

IAPS Secretary, Dr Peter Meagher commented that British law goes further than Irish law currently, and yet there are still issues surrounding training and regulation within British cosmetic surgery practice, as evidenced in the case of non-invasive treatments looked at in the Keogh Review. The view of the IAPS is that more often than not plastic surgeons in Ireland have not received specialist training and are “seldom or ever are on the specialist register” Dr Meagher said.

His concern is that patients who use unregulated clinics have no fall back if things go wrong. Often these are not even open round the clock, so patients have to rely on medical emergency care if they run in to problems following surgery.

Because of the lack of registration, Dr Meagher added that it was “hard to tell” how many patients may have suffered because of this, but that anecdotal evidence indicated that it was happening.

BAAPS President Rajiv Grover has spoken out over his concern that recommendations made to government months ago are not being implemented – a view that is echoed by much of the aesthetic medical industry.

In April of this year the final Keogh Review report was published and presented to government. In it, recommendations were made that the administration of non-invasive cosmetic procedures such as Botox and fillers should be carried out by qualified medical practitioners alone. At the time the review found the current deregulation of dermal fillers a “crisis waiting to happen.”

Now, six months after the recommendations were made, there has still been no action to tighten regulation within the industry which Grover deems to be “shameful”, adding:

“I like to hope that something will improve (however) there have been reviews before and none of them were taken up.”

The British Association of Dermatologists reaffirms his view and has responded in kind to the so-far lack of parliamentary response on the matter. In a statement spokesperson Deborah Mason said:

“When things go wrong with dermal fillers clients do not go back to their beauty therapist but seek help from dermatologists. This may give the false impression that these procedures are safe to those not medically skilled to deal with or understand the risks.

“We would like to see specific training in these procedures for medical and non-medical practitioners.”

The Department of Health has responded to the criticisms in a statement, stating:

“The government agrees with the principles of Sir Bruce Keogh’s recommendations and we are considering the report carefully and will put our detailed response to parliament shortly.”

Cosmetic Courses offers aesthetic training to qualified medical professionals from centres in Buckinghamshire and Manchester. Call us on 01844 390110 for details.